Use of tunica vaginalis graft for repair of traumatic bilateral testicular rupture after gunshot: a case report

Abstract

Bilateral testicular injuries are rare. However, the incidence of these injuries has been increasing in wartime. We describe the case of gunshot wound of the both testicle caused by high velocity bullets. The patient was managed by surgical exploration, debridement and repaired of both testis using tunica vaginalis. During the follow up, the left testis was not viable and there was a need for orchiectomy; in a follow-up of 4 months, ultrasonography showed a viable right testis with minimal atrophic change and the patient reported to have normal erection with borderline hormonal function. We describe this case of bilateral testicular rupture, which was repaired using tunica vaginalis as graft, with attention to the management and outcome of this injury process.

Scrotal self-inflicted gunshot injuries: report of two consecutive cases and literature review

“…It has been observed that the extent of the injury is determined by the velocity of the projectile, its structure, integrity and the distance from the gun to the target [6][7][8]14]. Thus, the higher the velocity, and the closer the target, the more extensive the injury [14][15][16]. Therefore, going by the extent of injuries observed in the two patients, it can be deduced that the guns were of the low velocity caliber (200-300 m/sec).…”

“…In this series, out of three (3) testes injured, two (66.7%) were salvaged by primary repair alone. Where the testis is viable but primary approximation, due to deficiency of the tunica albuginea is not feasible, tunica vaginalis graft can be used to interpose the defect and effect a repair [15,23,25,26]. For devitalized, non-viable testes, orchidectomy is the treatment of choice.…”